Sometimes I work with healthcare providers who don't seem to care if their patients are scared or in pain. It doesn't seem to factor into their decisions -- it doesn't cause them to be more gentle, or more reassuring, or to think through whether an uncomfortable procedure is truly necessary.
This is, uh... traumatizing! Obviously!
Disproportionately, I see this from nurses and assistants. Sometimes MDs act this way too, but I think I see it more from lower-level healthcare workers.
On a few occasions, nurses have *insisted* that they needed to do some painful thing to me, to check it off some list. I'd tell them I SERIOUSLY doubt it's necessary in my case. I'd emphasize how bad it is for me. And they wouldn't care. They'd act like I'm a nuisance for whining.
And then later, the doctor would come in, and I'd learn that the procedure was -- as I thought -- unnecessary.
This is something I keep in mind for medical appointments these days. I do research ahead of time. I learn about what procedures they might want to do, why those procedures are done, and what can go wrong.
Sometimes I mentally brace myself: I may end up alone in a room with someone who feels fully entitled to touch my body, and I need to be ready to firmly NOT CONSENT.
More broadly, I've been treating healthcare providers as an unreliable, secondary source of information. Good for visually assessing things I don't have the tools/training to assess myself, but even then, I take their claims with a grain of salt.
If I fully trusted whatever healthcare providers told me, I would've been screwed on *so many occasions*. Many healthcare providers are amazing, but you can't know that ahead of time.
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kip
in reply to kip • •Ben Weinstein-Raun
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in reply to Ben Weinstein-Raun • •Rick Korzekwa
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Nikki Bee
in reply to kip • •Hi, apologies for dropping by on a post about something pretty personal as a stranger, but as someone who's both suffered from fairly traumatic healthcare stuff _and_ got friends working in nursing and midwifery, I had some thoughts on this.
I would guess that it's much more common for doctors to have time built in to their schedule and specific training to talk to patients, and from hearing nurses talk about their training, I don't think either of those things is commonly true. Nurses are given procedures to follow and have limited context for them. Doctors on leave are often replaced (in the UK at least) from a pool of extra-well-paid "locum" consultants, whereas nurses are relatively often chronically understaffed or borrowed from other areas of a hospital and practice where they might not have equivalent training.
A midwife friend told me that in midwifery there was a very strong trend to medicalise childbirth as a procedure (more caesareans amongst other interventions) and then a pushback against that as research and community knowledge said "no actually, mothers'
... show moreHi, apologies for dropping by on a post about something pretty personal as a stranger, but as someone who's both suffered from fairly traumatic healthcare stuff _and_ got friends working in nursing and midwifery, I had some thoughts on this.
I would guess that it's much more common for doctors to have time built in to their schedule and specific training to talk to patients, and from hearing nurses talk about their training, I don't think either of those things is commonly true. Nurses are given procedures to follow and have limited context for them. Doctors on leave are often replaced (in the UK at least) from a pool of extra-well-paid "locum" consultants, whereas nurses are relatively often chronically understaffed or borrowed from other areas of a hospital and practice where they might not have equivalent training.
A midwife friend told me that in midwifery there was a very strong trend to medicalise childbirth as a procedure (more caesareans amongst other interventions) and then a pushback against that as research and community knowledge said "no actually, mothers' emotional wellbeing and also their agency and involvement in decision-making is IMPORTANT and paying attention to those lead to better outcomes". Surely similar things are important across many many many other areas of medical practice, but I bet they're less well researched and that there's less history of that kind of less-professionalised-care being a valued skill of its own in other fields.
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kip
in reply to Nikki Bee • •Hi there!
Yeah, IME, it feels like nurses are working with checklists, whereas doctors are more oriented around actually solving my problem. (This is part of what I was thinking with "doctors are more intelligent and require more training" -- their work involves much more cognitive labor.)
It confuses me, though, that I get so much pressure and pushback when I say "I don't want to do X." Do they get reprimanded for failing to complete procedures, even when the reason is "the patient refused"?
Childbirth is one of the most intense experiences someone can go through, so this sounds really bad in that context! I'm glad there's pushback.
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Nikki Bee
in reply to kip • •I'm talking second-hand and haven't done either job myself, but I get the impression that's part of it: nurses are often carrying out treatment decisions that someone else (hospital policy or a doctor) has made. I've also heard of places having a pretty dysfunctional culture of hierarchy where it's not considered OK for a very experienced nurse to question the decision of a doctor, which I've gotta imagine can fit into this type of situation.
My impression is that this isn't about individual intelligence so much as that one is a job which entrusts them with decision-making authority and budgets time to learn about the needs of the patient into the work day, and the other is a job which about carrying out work planned by other people (routine things determined by hospital policy, or patient-specific stuff decided by a doctor/surgeon).
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Rick Korzekwa
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kip
in reply to Rick Korzekwa • •I'm glad you've had a good time with nurses. There's a lot of variance, so I expect many people feel this way overall.
Yes -- I think in many of these situations, the provider does not believe that the patient is suffering as much as they claim. As a patient, it's very distressing. I've had a lot of good healthcare experiences as well, but bad experiences have the potential to be intensely bad.
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